精神科护理：速成包

公式表、每个专题的关键方法步骤和 6 道练习题，完整解答附在最后。

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1公式与方法

精神科护理

方法

  1. 判断是否存在即时风险：自杀、暴力、药物急症或躯体疾病。
  2. 先保障安全：观察、移除危险物品、缓和局面、停用有害药物、寻求帮助。
  3. 选择治疗性回应：承认感受、陈述现实，避免虚假的安慰和“为什么”式提问。
  4. 尊重权利：采用限制最少的方案，知情同意，以及保密及其限度。

2练习题

1.精神科护理中等

How may depression present differently in adolescents than in adults?

  1. AWith a high fever and a rash
  2. BWith irritability rather than obvious sadness
  3. CWith increased energy and less need for sleep
  4. DAlways with psychotic symptoms
2.精神科护理困难

A patient with schizophrenia has marked negative symptoms. He stays in bed most of the day and neglects his hygiene. Which nursing approach is most helpful?

  1. ALet him stay in bed, because negative symptoms cannot change
  2. BAgree a simple daily routine with small, achievable activities and give positive feedback
  3. CTell him firmly that he will lose his ward privileges unless he gets up and showers at once
  4. DWait until he asks to join activities before involving him
3.临床心理学中等

根据美国加利福尼亚州塔拉索夫案确立的义务，治疗师可能需要：

  1. A在任何情况下都对所有信息保密，无论对他人有何风险
  2. B拒绝治疗有暴力史的来访者
  3. C举报每一个表达愤怒的来访者
  4. D采取措施保护受到来访者严重威胁的可识别对象
4.临床心理学困难

哪项发现最能支持 5-羟色胺及其他单胺在抑郁中的作用，而不仅仅是环境因素？

  1. A每个经历丧失的人都会变得抑郁
  2. B在随机试验中，作用于单胺系统的药物比安慰剂更能减轻抑郁症状
  3. C无论社会和经济状况有多大差异，所有国家的抑郁发生率都相同
  4. D抑郁从不在家族中聚集
5.药理学中等

Why is directly observed therapy (DOT) often used for tuberculosis?

  1. AThe drugs work only if a nurse is present
  2. BTB drugs must always be given intravenously in hospital
  3. CPatients with TB cannot swallow tablets
  4. DTreatment lasts months, and missed doses cause resistance
6.药理学困难

An older patient on amlodipine develops ankle swelling and is prescribed furosemide. She then becomes dizzy and falls. What does this sequence illustrate?

  1. AA prescribing cascade
  2. BEnzyme induction
  3. CA type B allergic reaction
  4. DDrug tolerance

3溶液

1.精神科护理

答案: B · With irritability rather than obvious sadness

为什么是这个答案

In children and adolescents, depressed mood can appear as irritability. Other signs include falling school performance, withdrawal from friends, and changes in sleep and appetite.

答案

B · With irritability rather than obvious sadness
2.精神科护理

答案: B · Agree a simple daily routine with small, achievable activities and give positive feedback

为什么是这个答案

Negative symptoms such as avolition and anhedonia improve with structure, step-by-step goals and encouragement. Punishment or waiting for the patient to start on his own usually makes withdrawal worse.

答案

B · Agree a simple daily routine with small, achievable activities and give positive feedback
3.临床心理学

答案: D · 采取措施保护受到来访者严重威胁的可识别对象

为什么是这个答案

塔拉索夫案的判决认为，当来访者对可识别的受害者构成严重暴力危险时，治疗师有义务采取合理措施保护该人。

答案

D · 采取措施保护受到来访者严重威胁的可识别对象
4.临床心理学

答案: B · 在随机试验中，作用于单胺系统的药物比安慰剂更能减轻抑郁症状

为什么是这个答案

平均而言，针对单胺的抗抑郁药优于安慰剂，尽管优势不大。这支持生物因素的作用，但并不能说明仅仅是低 5-羟色胺导致了抑郁。

答案

B · 在随机试验中，作用于单胺系统的药物比安慰剂更能减轻抑郁症状
5.药理学

答案: D · Treatment lasts months, and missed doses cause resistance

为什么是这个答案

Standard TB treatment usually lasts six months or more with several drugs. Poor adherence leads to relapse and multidrug-resistant TB, so supervised dosing improves completion.

答案

D · Treatment lasts months, and missed doses cause resistance
6.药理学

答案: A · A prescribing cascade

为什么是这个答案

In a prescribing cascade, an adverse effect of one drug is mistaken for a new condition and treated with another drug, which brings new risks. Amlodipine oedema does not respond well to diuretics; reviewing the original drug is better.

答案

A · A prescribing cascade

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